Sunday, 18 August 2013

Tales from the Darkside 004: Marshall DC’s pennies in the collection box for A&Es.

The recent news
about the UK’s prime minister’s generous £ 500 million(over 2 years) to be spent to ease the A&E crisis (= not met politically generated target)
is really a drop in the ocean according to our Newbie Comm GPs. If you do the
maffs then £ 250 million a year spent equally over Englandshire’s 212 CCGs
equates to a Jeramiah bonus of about £ 1.18 million per CCG. However the Party
has announced that this money will be targeted on the worse performing A&Es
some 50-60 we believe which equates if 50 is used as £ 5 million a year.

This is no
different to the UK’s state education system where if you perform well you do
not get extra to perform better instead the Party thinks that if you do badly
giving more money will make you do better.

NHS managers are
at best in the bottom third of the UK’s state education system and they like to
keep things very simple. So rather than attempt to see a problem in a broader
context which involves an alien process to most of them called thinking they
instead focus on simple things called targets.

Targets are
black and white to an elite cohort who left schools with minimal qualifications
and suddenly realized they had to work to survive. With minimal qualifications
they answered the NHS needs you ads in droves. Hence NHS Staffordshire. Targets
good, patients bad.

So for years NHS
managers have persued targets and ignored patients for they get treated for
free and one of their targets is the A&E 4 hour wait. No NHS manager will
ever have had to prioritize in the way that the GPs we report on have had to in
their previous lives.

They will not have had to say which comes first
like a child not breathing and a cardiac arrest in the next door cubicle. 3
members of staff available who do we treat first and where do we deploy? Major
car crash 6 severely injuried victims, 5 dead and sudden appearance of a ruptured
aortic annerysm at 01.00 and 20 sore throats and drunks who could not see their
GPs until tomorrow hence urgent attendance at A&E to be seen in 4
hours. 5 nurses and 2 doctors to cover. Only the 4 hour wait target is
important here to managers for all of the above must be seen within 4 hours or
else. Medical care is an optional extra as are appropriate staffing levels.

The NHS manager concentrate
on the “target” that all of the above have to be seen within 4 hours. Now some
of the above can wait and will eventually be treated and come to absolutely no
harm in doing so. Working out which is the difficult bit.

So if you are
not aware of this many PCTs have pumped millions and we are talking millions
into meeting the A&E target with little return if any. Marshall DC thinks
that chucking cash at a non problem is the solution while he, and his secretary
of state for health Khunta “no clue about medicine”, ignore what has gone
before if either of them actually knew.

If any fellow
journos at any of the medical magazines the doctors we report on read want to
do a FOI request for how much money PCTs have squandered over the past few
years on their local A&E departments to meet a target we suspect that the
amount of money on offer now to the few will pale into insignificance compared
with the amounts that have been wasted by all PCTs in years gone by. You might
also want to ask if other departments have received similar extra amounts over
the years.

If we assume for
the sake of argument that local Soviets have all applied £ 5 million a year to
“solve” their local A&E “crisis” you can see that based on these figures at
least £ 1.06 billion a year has been squandered each year over the past few years
to address a target and will contune to be spent as well as Dave’s little extra.
This is not spent on patient care this is spent (wasted) on target care.

The cause of the
problem is political not medical and you can pump money in ad infinitum. The non paying patients will not care they will just
keep coming for there is no comeback.

The NHS is
finite the politicians’ and patients’ demands are infinite. £ 500 million/£ 108
billion = 0.0046% increase in total health spending.

Praise be to the Party for once again pissing in
the wind and ignoring the gale they created and wondering why they keep getting
their feet wet.

About Me

Contact Northern Doc:
NorthernDr@googlemail.com
Northern Doc was once a blog originally written by a group of GPs in Northernshire and expressed their experiences and frustrations of working in today's NHS. The pieces were compiled at social meetings after work and published anonymously in a once free society. Following the Government's Medical Council clamp down on freedom of thought, speech and expression by doctors and our belief that the views of a few doctors DO NOT represent the views of the profession as a whole their views will now be written by and published by a journalist who has previously contributed to the blog by virtue of social ties. Any inference that the word Doc means a doctor is now purely coincidental. This is as of the 22 April 2013.